And then wanted to explain why you should be beaming ear-to-ear about vaccine data. Why would an infection trigger all of this testing, masking, life halting? Because severe illness/hospitalizations/deaths occur. All vaccines to date prevented hospitalizations/deaths completely.
Severe illness prevented completely in Moderna/Pfizer/AztraZeneca trials; 85% across regions (even in South Africa - South Africa variant there) in J&J trials and immune response from 1 dose may keep on giving (remember, outcomes evaluated 14-28 days out due to expediency)
But as I wrote yesterday, immunogenicity from 1 dose of J&J likely extends beyond 14-28 days - keeps on going so likely more protection over time - see graphs in this paper. Two-dose trial still going. Finally, S. Africa variant is one with less protection
nejm.org/doi/full/10.10…
from moderate disease in J&J trial with 1 dose and Moderna already making booster shot for this variant if needed (others can too nimbly). Finally, control in a population needs less efficacy than what we've seen with these vaccines.
wsj.com/articles/moder…
And why will restrictions end? Because restrictions put into place not because COVID is mild, but because of hospitalizations/deaths/severe disease. As those stop, it won't be tenable, prudent or cost-effective to test everyone when SARS-CoV-2 rendered toothless -public health
will need to resume work on terrible health maladies like housing and food insecurity, other infections (HIV, malaria, tuberculosis to name some), childhood vaccinations, overdose prevention, mental health. many of which exacerbated in this pandemic.
nytimes.com/interactive/20…

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More from @MonicaGandhi9

30 Jan
Know very tempting to feel nervous about variants. Please don't: 1) RNA viruses do mutate and those more fit spread more readily; 2) SARS-CoV-2 has much lower mutational rate than influenza A - we are seeing more because transmission high, want to tamp down (& now sequencing);
3) Vaccines do not generate just antibody response, but T cell responses (measured in all 3 trials published) and B cell responses). So if neutralizing antibodies slightly lower in vaccinated blood to a variant (and not yet lower in clinically significant way), remember T cells.
4) So far, all of these vaccines involve genetic material that code for the spike protein/RBD- mRNA in mRNA vaccines and double-stranded DNA in adenovector vaccines. Sequences of genetic material can be "tweaked" to respond to variants as needed; 5) As tweeted before, efficacy
Read 4 tweets
29 Jan
Wonderful news about the Johnson&Johnson vaccine! Let me explain (and also let me tell you I was just on an interview with Dr. Paul Offit, who believes - like me- that control is nigh). J&J vaccine press release here:
jnj.com/johnson-johnso…
J&J vaccine is a modified cold virus adenovirus (this vector doesn't replicate or cause illness in humans) with double stranded DNA coding the spike protein of SARS-CoV-2 inside. Nice explanation of NYT of how it works. The adenovirus "vector" (carrier)
nytimes.com/interactive/20…
gets the DNA inside host cell nucleus where it is "transcribed" into mRNA and then you make the spike protein of the virus % raise immune response against it. Initial phase I/II data from NEJM showed high immunogenicity of 1st dose that went up over time.
nejm.org/doi/10.1056/NE…
Read 10 tweets
29 Jan
At risk of upsetting people, I need to address why I think teachers should feel very safe going to in-person learning after vaccination. Let's start with why COVID-19 was a bad virus and how vaccines defang this virus and then let me address transmission one more time. As said
many times, Moderna and Pfizer phase 3 trials were meant to assess the risk of COVID-19 infection with symptoms as they were designed for expediency. So, 1st outcome was 1) do you have any symptoms suggestive of COVID-19, we will swab and see if you have COVID-19? 2nd outcome was
did you get severe disease from COVID-19?. In terms of 1st outcome to look at, 95% of COVID-19 cases with symptoms occurred in people who got placebo, not vaccine. Vaccine massively reduced chance of getting COVID-19 with symptoms. In 2nd outcome, all of the severe COVID-19
Read 16 tweets
28 Jan
Please don't panic too much about these new variants of SARS-CoV-2. Taking a step back, RNA viruses (viruses that use RNA as their genetic material rather than DNA; SARS-CoV is an RNA virus) have higher mutation rates than DNA viruses (like chickenpox).
jvi.asm.org/content/92/14/…
Their RNA-dependent RNA polymerases (which replicate the genetic material) do not "proofread" assiduously like DNA polymerases so random mutations occur and those that confer a "fitness advantage" (helps them replicate more efficiently) take off. See this:
biorxiv.org/content/10.110…
Mutations that lead to an enhancement of the ability of the spike protein to bind to the host's receptor (the ACE receptor) may be advantageous to the virus. Of 295,507 full-length genome sequences of SARS-CoV-2 worldwide, authors looked at mutations affecting that interface and
Read 5 tweets
18 Jan
What about COVID-19 vaccines in pregnancy? A question asked often. I think safe but wanted to discuss. I have worked in women & HIV for long time & drugs/vaccines/etc. not studied in pregnant & breastfeeding women despite FDA saying they should
fda.gov/media/90160/do…
Similarly, pregnant & breastfeeding women included in Pfizer/Moderna trials (at start) so can't specifically comment on this group. However, these are not "live" vaccines (weakened live virus) which we don't use in pregnant women. mRNA in these vaccines is inert and
degrades very quickly after being "translated" (made) into the spike protein and doesn't stick around. Therefore, this genetic material does NOT stay in your body and should not harm fetus in any way. The spike protein and the immune response you make against it should not harm
Read 4 tweets
17 Jan
Oh dear. I didn't read the post that had incited such confusion on here from a fellow scientist because I think polemics against fellow scientists is unmerited but I am beginning to get a hint that she slandered me (which happened before on a hypothesis our group had that reduced
viral #inoculum reduces severity of disease). I will take a small break from Twitter now as I have so much work. But please remember this. Scientists usually write academically and their "fame" is very circumscribed within academic circles & they usually don't get listened to
by anyone else! So, it is tempting and exciting to become "famous" in a pandemic and be listened to by so many. And any scientist right now is as lonely and miserable as anyone else during COVID-19 because we are all human and connection is a part of human existence. So, that
Read 6 tweets

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